Provider Demographics
NPI:1477570422
Name:TLC SPEECH SERVICES PC
Entity Type:Organization
Organization Name:TLC SPEECH SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:630-853-6012
Mailing Address - Street 1:309 W BURLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MAPLE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60151
Mailing Address - Country:US
Mailing Address - Phone:630-853-6012
Mailing Address - Fax:815-827-3792
Practice Address - Street 1:309 W BURLINGTON DR
Practice Address - Street 2:
Practice Address - City:MAPLE PARK
Practice Address - State:IL
Practice Address - Zip Code:60151
Practice Address - Country:US
Practice Address - Phone:630-853-6012
Practice Address - Fax:815-827-3792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILTC40640498POtherIL DEPART OF HUMAN SERVIC